Therapy indications in massive transfusion

Therapeutic Indications in Massive Transfusion (1)

Historically, aggressive fluid resuscitation with crystalloid/colloid is recommended to maintain normal blood pressure but they are complicated by pulmonary oedema, exacerbation of thrombocytopenia & coagulopathy due to haemodilution.

On the other hand, permissive hypotension, where systolic blood pressure of 80–100 mmHg is tolerated & have shown survival benefit in some studies.

There is insufficient evidence to recommend a specific RC:FFP:Plt ratio but should be based on clinical criteria & frequent monitoring of laboratory values. The institution should develop own MTP (Massive Transfusion Protocol) that includes ratio of blood component therapy which may reduce mortality & ARDS.